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Individual

CORTNEY K MONTGOMERY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APRN

Contact information

Practice address
315 E BROADWAY FL 4, LOUISVILLE, KY 40202
(502) 629-2500
(502) 629-2055
Mailing address
PO BOX 776347, CHICAGO, IL 60677-6347
(502) 272-5052
(502) 629-6217

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
3007673
KY
363LF0000X
Family Nurse Practitioner
71004254A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
20115800
IN
01
28206048A
LICENSE
IN
01
3007673
LICENSE
KY
05
7100244890
KY
01
71004254A
LICENSE
IN
Enumeration date
10/04/2012
Last updated
12/18/2020
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